Impact of Goals of Care on Resource Use at End of Life

Using a sub-sample from a larger study (NR014856), a team of researchers at Frances Payne Bolton School of Nursing, Case Western Reserve University, sought to exam­ine whether there were differences in resource use at EOL between patients with advanced cancer who identified goals of care focused heavily upon survival versus those who identified goals of care heavily focused on quality of life (QOL).

The larger study used a longitudinal descriptive study design and collected data on patients with a diagno­sis of stage 4 gastrointestinal or lung cancers. Data were collected at University Hospitals Seidman Cancer Center in Cleveland, Ohio, every 3 months until the end of the 15-month study period or patient death.

Subjects were asked at each time point, “Regarding your care, what is most important to you right now?” (Figure). Anchors on the 100-point visual analog scale were QOL and survival, with a value of 50 indicating a goal with equal weight given to both domains. Values greater than 50 indicated a goal of care that focused more on survival than QOL. Continue reading >